Apparatus and system for diabetes management

ABSTRACT

An apparatus and system diabetes management. The apparatus comprises a body which houses: (i) at least a first memory for storing data inputs corresponding at least to one or more components in a patient&#39;s present insulin dosage regimen and the patient&#39;s blood-glucose-level measurements determined at a plurality of times; (ii) a processor operatively connected to the at least first memory, the processor programmed at least to determine from the data inputs corresponding to the patient&#39;s blood-glucose-level measurements determined at a plurality of times whether and by how much to vary at least one of the one or more components of the patient&#39;s present insulin dosage regimen; (iii) a display screen operatively connected to the processor; (iv) a quantity of insulin; (v) a needle communicating with the quantity of insulin for delivering insulin to the patient; (vi) means for effecting delivery of a portion of the quantity of insulin to the patient via the needle; and (vii) metering means for controlling the portion of the quantity of insulin delivered to the patient via the needle.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.13/128,358, filed Jul. 21, 2011, which is the National Phase applicationof International Application No. PCT/AU2009/063989, filed 11 Nov. 2009,which designates the United States and was published in English, whichclaims priority to U.S. provisional application No. 61/113,252, filed 11Nov. 2008, and U.S. provisional application No. 61/257,886, filed 4 Nov.2009. Each of these applications, in their entirety, are incorporatedherein by reference.

FIELD OF THE INVENTION

The present invention pertains to apparatus and systems for diabetesmanagement, and more specifically to such apparatus and systems as areoperative to determined at a plurality of times whether and by how muchto vary at least one of the one or more components of a patient'spresent insulin dosage regimen, and to provide the means foradministering insulin doses.

BACKGROUND

Diabetes is a chronic disease resulting from deficient insulin secretionby the endocrine pancreas. About 7% of the general population in theWestern Hemisphere suffers from diabetes. Of these persons, roughly 90%suffer from Type-2 diabetes while approximately 10% suffer from Type-1.In Type-1 diabetes, patients effectively surrender their endocrinepancreas to autoimmune distraction and so become dependent on dailyinsulin injections to control blood-glucose-levels. In Type-2 diabetes,on the other hand, the endocrine pancreas gradually fails to satisfyincreased insulin demands, thus requiring the patient to compensate witha regime of oral medications or insulin therapy. In the case of eitherType-1 or Type-2 diabetes, the failure to properly control glucoselevels in the patient may lead to such complications as heart attacks,strokes, blindness, renal failure, and even premature death.

Insulin therapy is the mainstay of Type-1 diabetes management and one ofthe most widespread treatments in Type-2 diabetes, about 27% of thesufferers of which require insulin. Insulin administration is designedto imitate physiological insulin secretion by introducing two classes ofinsulin into the patient's body: Long-acting insulin, which fulfillsbasal metabolic needs; and short-acting insulin (also known asfast-acting insulin), which compensates for sharp elevations inblood-glucose-levels following patient meals. Orchestrating the processof dosing these two types of insulin, in whatever form (e.g., separatelyor as premixed insulin) involves numerous considerations.

First, patients measure their blood-glucose-levels (using some form of aglucose meter) on average about 3 to 4 times per day. The number of suchmeasurements and the variations therebetween complicates theinterpretation of these data, making it difficult to extrapolate trendstherefrom that may be employed to better maintain the disease. Second,the complexity of human physiology continuously imposes changes ininsulin needs for which frequent insulin dosage regimen adjustments arewarranted. Presently, these considerations are handled by a patient'sendocrinologist or other healthcare professional during clinicappointments. Unfortunately, these visits are relativelyinfrequent—occurring once every 3 to 6 months—and of short duration, sothat the physician or other healthcare professional is typically onlyable to review the very latest patient medical data. In consequence, ithas been shown that more than 60% of patients control their diabetes atsub-optimal levels, leading to unwanted complications from the disease.

Indeed, one of the major obstacles of diabetes management is the lack ofavailability of a patient's healthcare professional and the relativeinfrequency of clinic appointments. Studies have, in fact, establishedthat more frequent insulin dosage regimen adjustments—e.g., every 1 to 2weeks—improves diabetes control in most patients. Yet as the number ofdiabetes sufferers continues to expand, it is expected that thepossibility of more frequent insulin dosage regimen adjustments viaincreased clinic visits will, in fact, decrease. And, unfortunately,conventional diabetes treatment solutions do not address this obstacle.

The device most commonly employed in diabetes management is the bloodglucose meter. Such devices come in a variety of forms, although all arecharacterized by their ability to provide patients near instantaneousreadings of their blood-glucose-levels. This additional information canbe used to better identify dynamic trends in blood-glucose-levels.However, all conventional glucose meters are designed to be diagnostictools rather than therapeutic ones. Therefore, by themselves, evenstate-of-the-art glucose meters do not lead to improved glycemiccontrol.

One conventional solution to the treatment of diabetes is the insulinpump. Insulin pumps are devices that continuously infuse short actinginsulin into a patient at a predetermined rate to cover both basal needsand meals. As with manual insulin administration therapy, a healthcareprofessional sets the pump with the patient's insulin dosage regimenduring clinic visits. In addition to their considerable current expense,which prohibits their widespread use by patients with Type-2 diabetes,insulin pumps require frequent adjustment by the physician or otherhealthcare professional to compensate for the needs of individualpatients based upon frequent blood-glucose-level measurements.

An even more recent solution to diabetes treatment seeks to combine aninsulin pump and near-continuous glucose monitoring in an effort tocreate, in effect, an artificial pancreas regulating a patient'sblood-glucose-level with infusions of short-acting insulin. According tothis solution, real-time patient information is employed to matchinsulin dosing to the patient's dynamic insulin needs irrespective ofany underlying physician-prescribed treatment plan. While such systemsaddress present dosing requirements, they are entirely reactive and notinstantaneously effective. In consequence of these drawbacks, suchcombined systems are not always effective at controlling blood glucoselevels. For instance, such combined units cannot forecast unplannedactivities, such as exercise, that may excessively lower a patient'sblood-glucose level. And when the hypoglycemic condition is detected,the delay in the effectiveness of the insulin occasioned not only by thenature of conventional synthetic insulin but also the sub-dermaldelivery of that insulin by conventional pumps results in inefficientcorrection of the hypoglycemic event.

While the foregoing solutions are beneficial in the management and eventreatment of diabetes in some patients, or at least hold the promise ofbeing so, there continues to exist the need for an apparatus that iseasy to use so as to facilitate improved diabetes control in patients.

SUMMARY

The present invention comprehends an apparatus and system for diabetesmanagement. In one embodiment, the inventive apparatus comprises a bodywhich houses:

-   -   (i) at least a first memory for storing data inputs        corresponding at least to one or more components in a patient's        present insulin dosage regimen and the patient's        blood-glucose-level measurements determined at a plurality of        times;    -   (ii) a processor operatively connected to the at least first        memory, the processor programmed at least to determine from the        data inputs corresponding to the patient's blood-glucose-level        measurements determined at a plurality of times whether and by        how much to vary at least one of the one or more components of        the patient's present insulin dosage regimen;    -   (iii) a display screen operatively connected to the processor        and operative to display at least the recommended insulin dose;    -   (iv) a quantity of insulin;    -   (v) a needle communicating with the quantity of insulin for        delivering insulin to the patient;    -   (vi) means for effecting delivery of a portion of the quantity        of insulin to the patient via the needle; and    -   (vii) metering means for controlling the portion of the quantity        of insulin delivered to the patient via the needle.

In one embodiment, the apparatus may be for single-use only, meaningthat the quantity of insulin cannot be replenished upon exhaustionthereof.

In another embodiment, the apparatus is for multiple-use and thequantity of insulin is therefore able to be replenished. According tothis embodiment, the quantity of insulin may be contained in a cartridgethat is selectively removable from the housing so as to be replaceableupon exhaustion of the quantity of insulin therein.

In one embodiment, the body may further house a test strip port forreceiving a test strip. Per this embodiment, the processor is operativeto determine a patient's current blood glucose level measurement from asample of the patient's blood provided on a test strip. Also per thisembodiment, the display may, optionally, be operative to display apatient's current blood glucose level measurement.

According to one feature of the invention, means may be provided forcommunicating data from the memory to a remote device for remotestorage. Such means are particularly, though not exclusively, suited toemployment of the apparatus for single-use only, according to which datastored in the apparatus may be remotely stored, including, for example,for later transfer to a second, like apparatus.

Per another feature, means may be provided communicating data from thememory of the apparatus directly to a second, like apparatus fordiabetes management. Such means are particularly, though notexclusively, suited to employment of the apparatus for single-use only.

Per yet another feature of the invention, the apparatus may furthercomprise means for preventing a patient from administering an injectionwhen there is an insufficient quantity of insulin remaining in theapparatus.

The present invention further comprehends a system for diabetesmanagement, comprising:

-   -   (a) a device including:        -   (i) at least a first memory for storing data inputs            corresponding at least to one or more components in a            patient's present insulin dosage regimen and the patient's            blood-glucose-level measurements determined at a plurality            of times; and        -   (ii) a processor operatively connected to the at least first            memory, the processor programmed at least to determine from            the data inputs corresponding to the patient's            blood-glucose-level measurements determined at a plurality            of times whether and by how much to vary at least one of the            one or more components of the patient's present insulin            dosage regimen;    -   (b) an apparatus, remote from the device, comprising a body        housing:        -   (i) at least a first memory;        -   (ii) a processor operatively connected to the at least first            memory;        -   (iii) a display screen operatively connected to the            processor;        -   (iv) a quantity of insulin;        -   (v) a needle communicating with the quantity of insulin for            delivering insulin to a patient;        -   (vi) means for effecting delivery of a portion of the            quantity of insulin to the patient via the needle; and        -   (vii) metering means for controlling the portion of the            quantity of insulin delivered to the patient via the needle;            and    -   (c) means for communicating data between the device and the        apparatus, the data including at least data corresponding to a        current recommended insulin dose.

In one embodiment, the apparatus may be for single-use only.Accordingly, the quantity of insulin cannot be replenished.

In another embodiment, the apparatus is for multiple-use and thequantity of insulin is therefore able to be replenished. According tothis embodiment, the quantity of insulin may be contained in a cartridgethat is selectively removable from the housing so as to be replaceableupon exhaustion of the quantity of insulin therein.

According to one feature of the invention, the body further houses atest strip port for receiving a test strip, and the processor of theapparatus is operative to determine the patient's current blood glucoselevel measurement from a sample of the patient's blood provided on atest strip, and wherein further the means for communicating between thedevice and the apparatus are further operative for communicating thepatient's blood glucose measurement between the apparatus and thedevice.

Per yet another feature of the invention, the apparatus may furthercomprise means for preventing a patient from administering an injectionwhen there is an insufficient quantity of insulin remaining in theapparatus.

BRIEF DESCRIPTION OF THE DRAWINGS

For a better understanding of the invention, and to show more clearlyhow it may be carried into effect according to one or more embodimentsthereof, reference will now be made, by way of example, to theaccompanying drawings, showing exemplary embodiments of the presentinvention and in which:

FIG. 1 is perspective view of the apparatus for diabetes managementaccording to an exemplary embodiment;

FIG. 2 is a perspective view of the apparatus for diabetes managementaccording to a second exemplary embodiment;

FIG. 3 is a diagrammatic depiction of the inventive system according toa first exemplary embodiment thereof;

FIG. 4 is a diagrammatic depiction of the inventive system according toa second exemplary embodiment thereof; and

FIG. 5 is a diagrammatic depiction of the inventive system according toa third exemplary embodiment thereof.

WRITTEN DESCRIPTION

As required, detailed embodiments of the present invention are disclosedherein. However, it is to be understood that the disclosed embodiment ismerely exemplary of the invention that may be embodied in various andalternative forms. Therefore, specific structural and functional detailsdisclosed herein are not to be interpreted as limiting, but merely as arepresentative basis for teaching one skilled in the art to variouslyemploy the present invention.

The accompanying drawings are not necessarily to scale, and somefeatures may be exaggerated or minimized to show details of particularcomponents or elements.

As used herein, the term “insulin dose” means and refers to the quantityof insulin taken on any single occasion, while the term “insulin dosageregimen” refers to and means the set of instructions (typically definedby the patient's physician or other healthcare professional) definingwhen and how much insulin to take in a given period of time and/or undercertain conditions. One conventional insulin dosage regimen comprisesseveral components, including a long-acting insulin dosage component, aplasma glucose correction factor component, and a carbohydrate ratiocomponent. Thus, for instance, an exemplary insulin dosage regimen for apatient might be as follows: 25 units of long acting insulin at bedtime;1 unit of fast-acting insulin for every 10 grams of ingestedcarbohydrates; and 1 unit of fast-acting insulin for every 20 mg/dL bywhich a patient's blood glucose reading exceeds 120 mg/dL. In thecontext of this disclosure, a “current” insulin dose equates to thenumber of insulin units the patient needs to administer on the basis ofthe latest blood-glucose-level measurement and his or her prevailinginsulin dosage regimen.

Referring now to the drawings, wherein like numerals refer to like orcorresponding parts throughout the several views, the present inventionis generally characterized as an apparatus 10 for diabetes management,the apparatus comprising a body 11 which houses:

-   -   (i) at least a first computer-readable memory (not shown) for        storing data inputs corresponding at least to one or more        components in a patient's present insulin dosage regimen and the        patient's blood-glucose-level measurements determined at a        plurality of times;    -   (ii) a processor (not shown) operatively connected to the at        least first memory, the processor programmed at least to        determine from the data inputs corresponding to the patient's        blood-glucose-level measurements determined at a plurality of        times whether and by how much to vary at least one of the one or        more components of the patient's present insulin dosage regimen;    -   (iii) a display screen 12 operatively connected to the        processor;    -   (iv) a quantity of insulin (not visible) disposed in an internal        opening 13 in the body 11;    -   (v) a needle 14 communicating with the quantity of insulin for        delivering insulin to the patient;    -   (vii) means for effecting delivery of a portion of the quantity        of insulin to the patient via the needle; and    -   (vi) metering means for controlling the portion of the quantity        of insulin delivered to the patient via the needle (FIGS. 1 and        2).

The data inputs corresponding at least to one or more components in apatient's present insulin dosage regimen and the patient'sblood-glucose-level measurements determined at a plurality of timesstored in the at least first memory may, by way of non-limiting example,comprise those data inputs described in the inventions as set forth inUS Published Applications 20090253970 and 20090253973, the disclosuresof which published patent applications are incorporated herein byreference in their entireties. Relatedly, operation of the processor toat least determine from the data inputs whether and by how much to varyat least one of the one or more components of the patient's presentinsulin dosage regimen may, by way of non-limiting example, correspondto operation of the inventions as set out in the aforesaid US PublishedApplications 20090253970 and 20090253973. As explained more fullytherein, the operation of the exemplary embodiments of those inventionsis characterized by the determination of whether and by how much to varyone or more components of a patient's insulin dosage regimen based uponthe determined efficacy of that regimen in view of blood glucose levelmeasurements recorded as of the time of the determination. As anon-limiting example, determination of whether and by how much to vary apatient's present insulin dosage regimen is undertaken both on the basisof evaluations conducted at predefined time intervals (every 7 days, forexample) as well as asynchronously to such intervals. The asynchronousdeterminations will evaluate the patient's blood-glucose-level data forsafety each time a new blood-glucose-level measurement is received todetermine whether any urgent action, including any urgent variation tothe patient's present insulin dosage, is necessary. More particularly,each time a new patient blood glucose-level measurement is received intothe memory it is accessed by the processor and sorted and taggedaccording to the time of day the measurement was received and whether ornot it is associated with a certain event, e.g., pre-breakfast, bedtime,nighttime, etc. Once so sorted and tagged, the new and/or previouslyrecorded blood-glucose-level measurements are subjected to evaluationfor the need to update on the basis of the passage of a predefinedperiod of time measured by a counter, as well as the need to updateasynchronously for safety. For instance, a very low blood glucosemeasurement representing a severe hypoglycemic event or the accumulationof several low measurements in the past few days may lead to an updatein the patient's insulin dosage regimen, while an update to that regimenmay otherwise be warranted if a predefined period of time (e.g., 7 days)has elapsed since the patient's insulin dosage regimen was last updated.If an excessive number of such hypoglycemic events is not indicated,then the algorithm queries whether or not it is time to update thepatient's insulin dosage regimen irrespective of the non-occurrence ofhypoglycemic events, and based instead upon the passage of a predefinedinterval of time (e.g., 7 days) since the need to update the patient'sinsulin dosage regimen was last assessed. If such an update is notindicated, i.e., because an insufficient time interval has passed, thenno action is taken with respect to the patient's insulin dosage and thealgorithm ends until the next blood glucose-level measurement data areinput.

Where, as in the embodiment of FIGS. 1 and 2, the memory and processorare housed in the body 11 of the apparatus, data entry means, such asthe illustrated single or multi-function buttons or keys 17, areprovided to facilitate the entry of, for example and without limitation,one or more of the data inputs corresponding at least to one or morecomponents in a patient's present insulin dosage regimen.

Power to operate the apparatus, including the display and processor, maybe provided by one or more batteries (not shown) disposed in the body11. These one or more batteries may be rechargeable or single-use,replaceable or irreplaceable.

The means for effecting delivery of a portion of the quantity of insulinmay take the form of a plunger 15 operative in known fashion to dispensea portion of insulin through the needle 14 upon actuation of theplunger. Such means are found in conventional insulin pens. Of course,any other means employed to dispense insulin in conventional insulinpens may be substituted.

In order to control the portion of the quantity of insulin delivered tothe patient via the needle 14, metering means are provided. In one form,such metering means may comprise any mechanism employed in conventionalinsulin pens, for instance, to ensure that actuation of the plunger 15effectuates delivery of only a defined portion of insulin. According tosuch construction of the apparatus, unlimited actuation of the plunger15 dispenses a predefined portion of insulin via the needle 14. Themetering means preferably, though not necessarily, include a dial orother mechanism the selective movement of which would limit actuation ofthe plunger 15 in predefined increments corresponding to predefinedmeasurements of insulin. A display 16 provided on the apparatus 10indicates the current setting of the metering means so that the patientcan know how much insulin will be dispensed upon actuation of theplunger 15. Of course, such display may be provided on the displayscreen 12 in the alternative. Thus, by actuation of the metering means,a patient can, as desired, modify the apparatus so that actuation of theplunger will dispense a portion of the quantity of insulin correspondingto a recommended insulin dose corresponding to the processor'sdetermination of a recommended insulin dosage regimen (which may be thepatient's existing regimen or a regimen modified according to thealgorithm employed by the processor).

In an alternative embodiment, the delivery means may comprise anelectro-mechanical device disposed in the body 11 and operative toautomatically effect delivery of a portion of the quantity of insulinvia the needle 14 upon actuation of one of a plurality of single-purposeor multi-function buttons 17 provided on the apparatus. Furtheraccording to this embodiment, the metering means are likewise automatic.Once a recommended insulin dosage regimen has been determined by theprocessor (whether that regimen is an existing or modified regimen), theelectro-mechanical device is automatically adjusted by the processor sothat the subsequent actuation of the delivery means (such as, forinstance, via on ore more of the buttons 17) delivers to the patient adose of insulin corresponding to a recommended current insulin dose,determined by the processor, that may be displayed on the display screen12.

According to a still further embodiment, the delivery means may comprisethe manually actuated plunger heretofore described, while the meteringmeans may be an electro-mechanical device the operation of which isautomatically effected by the processor. In this fashion, the amount ofinsulin dispensed by a patient's manual actuation of the plunger wouldautomatically correspond to the recommended current insulin dose thatmay be displayed on the display screen 12.

As shown in FIG. 1, the quantity of insulin may be capable ofreplenishment upon exhaustion. To this end, the quantity of insulin maybe contained in cartridges (not depicted) that are selectively removablefrom the body 11 so as to be replaceable upon exhaustion of the insulinsupply therein. In order to permit access to the cartridges, body 11comprises, in the exemplary embodiment, a removable cap 11 a permittingaccess to the internal opening 13. The cartridges may be, for instance,in the form of compressible capsules (made, for instance, of plastic)acted upon by the plunger 15 during administration of a dose of insulin.It is also contemplated that such cartridges may take any form employedin conventional insulin pens.

Alternatively, the apparatus 10′ may, as shown in FIG. 2, be for “singleuse,” meaning that the quantity of insulin contained therein wouldsuffice for a limited number of doses and would thereafter be incapableof replenishment. For instance, it is typically the case thatconventional insulin pens contain about 300 insulin units [IU]. Asimilar amount could, without limitation, constitute the quantity ofinsulin contained in the apparatus 10′. For some patients, such anamount may last for 10 or more days, while for others this can representa daily consumption of insulin.

Needle 14 is preferably, though not necessarily, removably connected tothe body 11 so as to be disposable following use and thereafterreplaceable with a sanitary needle. Such removable connection, typicalof conventional insulin pens, may be accomplished in any conventionalfashion.

According to any of the foregoing, it is further contemplated that theapparatus 10, 10′ may include means for preventing a patient fromadministering an injection when there is no or an insufficient amount ofinsulin remaining in the apparatus. Such means may take the form of avisual warning, provided for instance on the display 12, 12′.Alternatively, or in addition, the apparatus may be programmed tophysically prevent operation of the delivery means. Such may comprise anelectro-mechanical device (which may be the same as or separate fromthose described in connection with the delivery and/or metering means),the operation of which is effected by the processor, which precludesactuation of the delivery means when it is determined by the processor(for instance, by calculation from the known initial quantity of insulinprovided, the number of times the delivery means are actuated, and thedose/portion of insulin delivered each time the delivery means areactuated) that an insufficient amount of insulin remains to deliver arecommended dose of insulin or another, predefined dose.

Optionally, the apparatus 10 may, as shown in FIG. 1, further comprise atest strip port of known construction housed in the body 11 forreceiving a test strip 20, such that the apparatus is capable of actingalso as a blood glucose meter. To this end, the processor is operativeto determine a patient's current blood glucose level measurement from asample of the patient's blood provided on a test strip 20. Per thisembodiment, display 12 may, optionally, provide a visual indication ofthe patient's current blood-glucose-level reading (e.g., “189 mg/dL” asshown in FIG. 1). According to this embodiment, the blood-glucose-levelreadings so determined comprise data inputs stored in the at least onememory and employed by the processor at least to determine whether andby how much to vary at least one of the one or more components of thepatient's present insulin dosage regimen (such as, for instance,according to the manner of operation of the inventions as disclosed inthe aforesaid US Published Applications 20090253970 and 20090253973).

Display screen 12 may, by way of non-limiting example, comprise an LCDscreen, the apparatus being programmed, according to convention, todisplay thereon such information displays as described herein (e.g., arecommended insulin dose corresponding to the processor-determinedinsulin dosage regimen). Where the apparatus 10 is operative todetermine blood glucose level measurements, and further includes dataentry means such as the buttons 17 herein described to permit thepatient and/or other user's to input data corresponding at least to oneor more components in a patient's present insulin dosage regimen anddata inputs related to the patient's blood glucose measurements, thedisplay screen 12 may be operative so as to display information displayscorresponding to at least the following:

a patient's current blood glucose level measurement;

an event associated with the said current blood glucose levelmeasurement;

a measurement for the number of carbohydrates associated with the saidevent; and

a recommended insulin dose corresponding to the processor-determinedinsulin dosage regimen.

Optionally, the display screen 12 may further be operative tosuccessively display a summary screen displaying simultaneouslyinformation corresponding to that provided on each of two or more of theforegoing information displays, including: a patient's current bloodglucose level measurement, an event associated with the said currentblood glucose level measurement, a measurement for the number ofcarbohydrates associated with the said event, and the recommendedinsulin dose.

According to the foregoing embodiment of the invention, the patientand/or other user is able to enter, in addition to, for instance, suchother data as corresponds to one or more components in a patient'spresent insulin dosage regimen, data related to a particular bloodglucose level measurement as determined by the processor from a sampleof the patient's blood. These data include, for instance and withoutlimitation, an appropriate event (e.g., breakfast, lunch, dinner)associated with a current blood glucose measurement as displayed ondisplay 12, as well as the number of carbohydrates associated with theevent.

Optionally, the apparatus 10 is programmed to enable a patient and/orother user to selectively override, such as by using one or more of theplurality of buttons 17, a recommended current insulin dose displayed onthe display screen 12. To the extent that the metering means areautomatically adjusted to effect delivery of the recommended insulindose, it is contemplated that the metering means would be furtheradjusted in response to any change in the recommended current insulindose made by the patient and/or other user.

Referring next to FIG. 3, it is further contemplated that the apparatus10′ be capable (particularly, though not exclusively, where fashionedfor single use) of communicating remotely (shown by the dashed line 50)with a device 100, such as a general-purpose computer (shown), cellphone, IPHONE, IPOD, PDA, etc., to which patient data, such as, forinstance, blood-glucose-level data, may be transferred and stored forlater use. Such remote communication may be accomplished via acommunication cable, for instance a USB cable, connectable to theapparatus and the remotely positioned device. Alternatively, such remotecommunication may be accomplished wirelessly, such as, for instance, viaany conventional wireless transmission protocol.

In similar fashion, it is further contemplated that the apparatus of thepresent invention (especially, although again not exclusively, wherefashioned for single-use) include means to communicate with likeapparatus via a communication cable, wirelessly, or any otherconventional communication means. This may be necessary, for instance,to transfer the patient's present insulin dosage regimen data, as wellas historical blood-glucose-level measurement data from the apparatus10′ the insulin supply of which is exhausted to a second, unspentapparatus. It will be appreciated that while such utility may beparticularly desired where the apparatus 10′ is of “single-use” design,it may also be desired in order to transfer such data as is stored in afirst apparatus to a second, like apparatus upon, or prior to, failureof the first.

Referring next to FIG. 4, there is depicted an alternative embodiment ofthe apparatus 10″ according to which a memory for storing data inputscorresponding at least to one or more components in a patient's presentinsulin dosage regimen and/or the patient's blood-glucose-levelmeasurements determined at a plurality of times, as well as a processoroperatively connected to memory and programmed at least to determinefrom the data inputs corresponding to the patient's blood-glucose-levelmeasurements determined at a plurality of times whether and by how muchto vary at least one of the one or more components of the patient'spresent insulin dosage regimen, are disposed in a device 100′ remotefrom the apparatus 10″. Device 100′, which may be a general-purposecomputer (as depicted), cell phone, IPHONE, IPOD, PDA or a purpose-builtunit, is adapted to communicate remotely (shown by dashed lines 50′)with the apparatus 10″ so that data may be transferred between thedevice 100′ and the apparatus 10″ (which includes a processor and atleast a first memory for storing such data but which is not, asindicated, itself operative to determine from the data inputscorresponding to the patient's blood-glucose-level measurementsdetermined at a plurality of times whether and by how much to vary atleast one of the one or more components of the patient's present insulindosage regimen). Such remote communication may be accomplished via acommunication cable, for instance a USB cable, connectable to theapparatus 10″ and the remotely positioned device 100′. Alternatively,such communication may be accomplished wirelessly, such as, forinstance, via any conventional wireless transmission protocol.

According to this embodiment, data corresponding to the patient'sinsulin dosage regimen and the patient's blood-glucose-levelmeasurements are stored in the memory of the device 100′, the processorof which is operative to access these data and determine at leastwhether and by how much to vary at least one of the one or morecomponents of the patient's present insulin dosage regimen. Uponcompletion of this determination, information corresponding to at leasta recommended current insulin dose may be transferred to the apparatus10″ to be displayed on display 12 to be acted upon in any manner asheretofore described.

Per this embodiment of the invention, the data corresponding to thepatient's insulin dosage regimen may be input on one or more occasionsby the patient's physician or other healthcare professional. Thepatient's blood-glucose-level measurements may be transferred to thememory of the device 100′ via a separate blood glucose meter or, to theextent that such functionality is provided in the apparatus 10″according to the embodiment as described herein, may be provideddirectly from the apparatus 10″.

Referring next to FIG. 5, it is further contemplated that the embodimentof FIG. 4 may be augmented by the provision of one or more additionaldevices 110 in communication (shown by dashed line 51, which representseither a wireless or wired connection) with the device 100′ tofacilitate remote entry of data, such as, for instance, datacorresponding to the patient's insulin dosage regimen. Per thisembodiment of the invention, data corresponding to the patient's insulindosage regimen may be input on one or more occasions by the patient'sphysician or other healthcare professional via the device 110 and thesedata thereafter transferred, such as, for instance and withoutlimitation, via the internet, to the memory of the device 100′.

The foregoing description of the exemplary embodiment of the inventionhas been presented for purposes of illustration and description. It isnot intended to be exhaustive of, or to limit, the invention to theprecise form disclosed, and modification and variations are possible inlight of the above teachings or may be acquired from practice of theinvention. The embodiment shown and described in order to explain theprinciples of the invention and its practical application to enable oneskilled in the art to utilize the invention in various embodiments andwith various modifications as are suited to the particular applicationcontemplated. Accordingly, all such modifications and embodiments areintended to be included within the scope of the invention. Othersubstitutions, modifications, changes and omissions may be made in thedesign, operating conditions, and arrangement of the exemplaryembodiments without departing from the spirit of the present invention.

The invention in which an exclusive property or privilege is claimed isdefined as follows:
 1. An apparatus comprising: a body housing; at leasta first memory for storing data inputs corresponding at least to one ormore components in a patient's present insulin dosage regimen and apatient's blood glucose-level measurements determined at a plurality oftimes; a processor operatively connected to the at least first memory,the processor programmed at least to determine from the data inputscorresponding to the patient's blood-glucose-level measurementsdetermined at a plurality of times within a predetermined time intervalwhether and by how much to vary at least one of the one or morecomponents of the patient's present insulin dosage regimen, wherein thepredetermined time interval is longer than a time period between any twoconsecutive blood-glucose-level measurements, and wherein saiddetermination occurs only after a passage of the predetermined timeinterval since the need to update the patient's insulin dosage regimenwas last assessed or if the most recent blood-glucose measurement is asevere hypoglycemic event or a plurality of hypoglycemic measurementshave been recorded during an elapsed portion of the predetermined timeinterval, and a display screen operatively connected to the processor; aquantity of insulin; a needle communicating with the quantity of insulinfor delivering insulin to the patient; means for effecting delivery of aportion of the quantity of insulin to the patient via the needle; andmetering means for controlling the portion of the quantity of insulindelivered to the patient via the needle.
 2. The apparatus of claim 1,wherein the quantity of insulin is contained in a cartridge that isselectively removable from the housing so as to be replaceable uponexhaustion of the quantity of insulin therein.
 3. The apparatus of claim1, wherein the quantity of insulin cannot be replenished upon exhaustionthereof.
 4. The apparatus of claim 1, wherein the body housing furtherhouses a test strip port for receiving a test strip, and the processoris operative to determine a patient's current blood glucose levelmeasurement from a sample of the patient's blood provided on a teststrip.
 5. The apparatus of claim 1, wherein the display screen isfurther operative to display a patient's current blood glucose levelmeasurement.
 6. The apparatus of claim 1, further comprising means forcommunicating data from the memory to a remote device for remotestorage.
 7. The apparatus of claim 1, further comprising means forcommunicating data from the memory to a second apparatus for takingblood glucose measurements and optimizing a patient's insulin dosageregimen over time.
 8. The apparatus of claim 1, further comprising meansfor preventing a patient from administering an injection when there isan insufficient quantity of insulin remaining in the apparatus.